Luminal A, luminal B, luminal-HER2 and HER2-enriched subtypes of breast cancer are highly correlated with lymph-node metastases and poor outcome in the patients with ALD metastases, but not in the patients with tumor-negative lymph-nodes.145 A high ratio of lymphovascular invasion and high expression of Ki67 are independently predictive of ALD metastases.146 Another potential biomarker, cytoplasmic chromosome segregation 1 Like is significantly associated with ALD metastases although it appears to have no regulatory effects on ALD metastases.147. The gene discussed is ERBB2; the disease is breast carcinoma.